Archives for May 3, 2019

Hello, I’m Dr. Jeff Kingsley and welcome to another edition of Riding in Cars With Researchers. Today we are going to talk about commodities and site differentiation.

Sites are Undifferentiated

As an example, let’s talk about copper. Copper is a commodity. What does that mean? It means there’s no differentiation. It means that if I pull copper out of one mine and copper out of a different mine, they’re both the same. Copper is copper. Because there is no differentiation, I can’t really tell the difference, so they should be priced the same. In fact, if one of the mines is willing to sell it to me cheaper, I should buy it from the cheaper mine because copper is copper. That’s what a commodity is. Sites have been commoditized. Actually, we largely did it to ourselves. Sites are undifferentiated. Sponsors and CROs, despite all of their intelligence, still struggle and fail to tell the difference from one site to another.

Sites are kind of all the same. They can’t figure out which sites are going to perform well and they can’t figure out how to define that in terms that matter and are reproducible. Meaning one site may perform really well on enrollment but had poor quality, and on the next trial their enrollment is worse, but their quality was better. They can’t figure it out and because they can’t figure it out, sites just kind of are all the same, somewhat interchangeable, like cogs in a wheel. Then sites are undifferentiated, which means that sites should be treated like commodities. That creates pricing pressure. That then creates a vicious cycle where sites are treated the same, therefore the low cost provider could prevail. Sites have to struggle to get appropriate contract and budget terms and that in turn inhibits a site’s ability to invest in infrastructure, quality management systems, and process improvement that would ultimately serve the industry better.

Breaking a Vicious Cycle

So where do we go from here? Well, we need to break the vicious cycle and we all need to take the first step. You’ve heard me talk about the need for sites to invest in infrastructure. Now from the context of this conversation, what does that mean? It means you sites out there, differentiate yourselves, show the industry that you are not a commodity. Show the industry that you are investing in QMS and process improvement. That you are investing in the best of the best team members. That you’re investing in technology to serve our customers better. Show them that you are not copper, show them that you are differentiated and that, in fact, they should pay you differently because you are delivering a higher quality service. One of us has to start this process. That’s how we will start to change how the industry interacts with sites.

Sites are the tip of the spear. We are the first interaction with patients, the first touch, the source of the data that then goes through the CROs, the CRMs and the other vendors and then to the Sponsors and then to the regulatory agencies. We are the very tip of the spear and yet we are treated as the least valuable part of that spear and it’s all really because of this concept of differentiation and commoditization.

My Call to Action

My rally cry to you, my Call to Action, is that we all start speaking on this topic. My Call to Action is that we start differentiating ourselves. We show the industry that we are not commodities, and we prove to the industry that we’re not making it up. If you say you’re not a commodity, but you behave like a commodity, you’re a commodity. We have to put our actions behind our words and that will start a virtuous cycle where the tip of the spear is treated as the important aspect of this vertical chain of activities that it is. That’s how we will ultimately improve clinical research. EQTCS: it matters. We are forging ahead and changing the healthcare of the future. This is how it happens, but incremental improvement. We can all make it just a little bit better. Thank you for riding along. Listen to my call to action. Do me a favor and help me out. I look forward to riding along with you again in the future.